Configuring selves through design: a critical study of self-tracking practices and digital inequalities in health insurance.


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PhD thesis: a PhD thesis.
Configuring selves through design: a critical study of self-tracking practices and digital inequalities in health insurance.
Presset Bastien
Ohl Fabien
Institution details
Université de Lausanne, Faculté des sciences sociales et politiques
Publication state
Writing in progress
Self-tracking (ST) is progressively finding its’ place in the health promotion programs of public health institutions, companies, and insurances. Going beyond technophilic discourses that present these innovations as neutral, my dissertation critically explores the reconfigurations of people’s lives and public health practices that they entail.
I rely on Akrich’s de-scription (1992) to follow a step-tracking application that distributes premium reductions upon daily completion of standardized objectives, from its development in a digital health laboratory financed by an insurance company to its laborious integration in policyholders’ daily lives. My analyses are based on observations among the designers, and interviews (n=45) and questionnaires (n=818) with end-users.
In the first part of the dissertation, I follow designers as they attempt to translate the technological promise to change users’ lifestyle in a technical architecture. I highlight their reliance on reductive cognitive models to configure users as ‘rational’ subjects (Woolgar, 1990). Doing so, I explore the cultural, technical, and organizational constraints that underpin the (re)production of the— criticized—‘neoliberal’ tracker (Lupton, 2016).
In the second part of the dissertation, I contrast designers’ script of user-technology interactions with users’ accounts of their actual encounters with the technology. First, I emphasize the negotiations and struggles that underpin the integration of physiological standards in daily life. Second, I demonstrate that digital divides are present both in the adoption and use of the technology, thereby challenging its public health ambitions, and strengthening health inequalities (Selwyn, 2004). Finally, I explore technology’s role in shaping users’ enactments of solidarity and thus question its disruptive effects on established models of insurance.
self-tracking, quantified-self, de-scription, digital divide, insurance, health promotion, Bourdieu, Akrich
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14/12/2022 15:55
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25/01/2023 8:08
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